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General NPI Number Information
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NPI Number | 1508416645
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Entity Type | Individual
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Provider Name | MANJU PHILIP-NEDUMAKEL
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Gender | Female
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 301 OXFORD VALLEY RD STE 1803A
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City | YARDLEY
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State | PA
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Zip | 19067-7725
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Country | US
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Telephone | 732-688-7468
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1044
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City | YARDLEY
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State | PA
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Zip | 19067
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Country | US
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Telephone | 732-688-7468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW020356
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License Number State | PA
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